Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $95.50 / $218.78	Facility	26	$70.79	$95.50	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $478.63 / $1,258.93	Professional		$194.98	$478.63	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $125.89 / $288.40	Professional	26	$66.07	$125.89	$288.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $512.86 / $549.54	Professional	52	$158.49	$512.86	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $269.15 / $616.60	Professional	TC	$114.82	$269.15	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $371.54	Professional		$144.54	$181.97	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $131.83	Professional	26	$52.48	$70.79	$131.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $114.82 / $204.17	Professional	TC	$87.10	$114.82	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $186.21 / $218.78	Professional	26	$123.03	$186.21	$218.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $602.56 / $891.25	Professional	TC	$371.54	$602.56	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $512.86 / $977.24	Professional		$229.09	$512.86	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $204.17	Professional	26	$63.10	$112.20	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $346.74 / $776.25	Professional	TC	$141.25	$346.74	$776.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $177.83 / $389.05	Professional		$70.79	$177.83	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $398.11 / $645.65	Professional		$208.93	$398.11	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $91.20 / $181.97	Professional	26	$70.79	$91.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $257.04 / $537.03	Professional	TC	$134.90	$257.04	$537.03
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $562.34 / $562.34 / $562.34	Professional	26	$562.34	$562.34	$562.34
Wellcare Facility/Professional Professional Modifier TC Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Professional	TC	$2,570.40	$2,570.40	$2,570.40